How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $316.23 Median $4,168.69 Typical High $7,585.78 | Facility | None | $316.23 | $4,168.69 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $812.83 | Professional | None | $229.09 | $316.23 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $724.44 | Professional | None | $446.68 | $467.74 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $10,964.78 | Facility | None | $512.86 | $1,000.00 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $977.24 | Professional | None | $323.59 | $524.81 | $977.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $213.80 Median $331.13 Typical High $616.60 | Professional | 62 · Two surgeons | $213.80 | $331.13 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $2,570.40 Typical High $3,235.94 | Facility | None | $537.03 | $2,570.40 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $549.54 Typical High $1,023.29 | Professional | None | $295.12 | $549.54 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $457.09 Typical High $1,000.00 | Professional | None | $269.15 | $457.09 | $1,000.00 |
Oscar Health Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $758.58 | Professional | None | $446.68 | $645.65 | $758.58 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $3,630.78 | Facility | None | $331.13 | $501.19 | $3,630.78 |
United Setting Professional Modifier None Typical Low $295.12 Median $562.34 Typical High $933.25 | Professional | None | $295.12 | $562.34 | $933.25 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $158.49 Typical High $208.93 | Professional | 52 · Reduced service | $114.82 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $63.10 Typical High $83.18 | Professional | 53 · Discontinued | $45.71 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $316.23 | Professional | 54 · Surgery only | $169.82 | $239.88 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $47.86 Typical High $63.10 | Professional | 55 · Aftercare only | $33.88 | $47.86 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $31.62 Typical High $41.69 | Professional | 56 · Pre-op care only | $22.91 | $31.62 | $41.69 |
Where Georgia sits
The same service costs 3.9 times more in Alaska than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Georgia· 16th of 51
$525
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.